What should be done if severe FGR is detected?
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Refer to a fetal medicine specialist.
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What should be done if severe FGR is detected?
Refer to a fetal medicine specialist.
What should be avoided in postpartum management?
Methyldopa.
What is one pathophysiological factor in pre-eclampsia?
Trophoblastic invasion of only the decidual segments of the spiral arterioles, leaving the intramyometrial segments intact.
What is the target blood pressure for treating hypertension in pre-eclampsia?
140 - 150/90 - 100 mmHg.
What is the recommended aspirin dosage for women with major risk factors for pre-eclampsia?
150 mg/day, ideally before 16 weeks of pregnancy.
What is the recommended calcium intake for women with low calcium levels?
1.2 - 2.5 g/day.
What are common symptoms of pre-eclampsia?
Frontal headache, double vision, blurred vision, scotoma, nausea and vomiting, epigastric or right hypochondrial pain.
What is associated with uteroplacental ischemia in pre-eclampsia?
An abnormal response of uteroplacental vessels to vasoactive substances.
What imaging is recommended for worsening neurological signs?
Cerebral imaging to exclude other causes.
What is required for delivery if S. Cr >1.1mg/dl?
Delivery is required.
What protein/creatinine ratio indicates abnormal proteinuria?
30 mg/mmol.
Is proteinuria mandatory for the diagnosis of pre-eclampsia?
No, proteinuria is no longer mandatory.
What medication is given for hypertension if BP is >160/110?
IV labetalol 20mg stat + 40mg after 15min, with infusion if persistently high.
What is the role of IV MgSO4 in managing pre-eclampsia?
To prevent and control seizures.
What blood pressure should be maintained to prevent complications?
Above 130/80 mmHg.
What is considered indicative of hypertension in pregnancy?
A systolic BP of ≥ 140 mmHg and/or a diastolic BP of ≥ 90 mmHg.
What are some prodromal symptoms of pre-eclampsia?
Headache and aura.
What defines pre-eclampsia?
De novo hypertension after 20 weeks of gestation accompanied by proteinuria and/or evidence of maternal acute kidney injury, liver dysfunction, neurological features, haemolysis or thrombocytopaenia and/or fetal growth restriction.
What is a consumptive coagulopathy?
It involves the microvasculature of the placenta, kidneys, and liver.
What should be done if pathological CTG is observed?
Urgent LSCS (Lower Segment Caesarean Section).
What should be monitored to prevent magnesium toxicity?
Pulse rate, BP, respiratory rate, oxygen saturation, deep tendon reflexes, and urine output.
What is the first test for evidence of target organ damage in pre-eclampsia?
Test for proteinuria using dipstick urinalysis.
What laboratory tests are important for assessing renal function in pre-eclampsia?
BU/S. Electrolytes and S. Creatinine.
What is eclampsia defined as?
The new onset of generalized tonic-clonic seizures in a woman with pre-eclampsia.
What is the recommended fluid balance to prevent pulmonary edema?
Total fluids around 80ml/hr until postpartum diuresis.
What role does maternal immune maladaptation play in pre-eclampsia?
It leads to an exaggerated maternal inflammatory response to the allogenic trophoblast.
What dysfunction is associated with impaired release of nitric oxide?
Endothelial dysfunction.
What signs may indicate pre-eclampsia?
Irritability, restlessness, epigastric tenderness, clonus, papilloedema, pulmonary edema features, oliguria, non-dependent edema.
What fetal assessments are important for evidence of growth and wellbeing?
Fetal biometry, amniotic fluid volume, and umbilical artery Doppler.
What role do anti-angiogenic factors play in pre-eclampsia?
They could play a central role in the systemic vascular dysfunction characteristic of pre-eclampsia.
